BOBBY HARRISON: Leadership set to prevent Medicaid expansion vote

JACKSON – Gov. Phil Bryant’s call announcing the special session and its topic should not prevent the Legislature from voting on Medicaid expansion.
Let me repeat that – the proclamation issued by the governor should not prevent a vote on Medicaid expansion.
But the Republican leadership – the governor, Speaker Philip Gunn and Lt. Gov. Tate Reeves – are so dead-set against expansion, apparently so fearful to allow the full Legislature to vote on the issue – that they most likely will take other measures in the special session to try to prevent that vote.
Of course, the Legislature is returning in special session Thursday to take up funding and reauthorizing the Division of Medicaid for the new fiscal year, which begins Monday. Without legislative action, it is uncertain what will happen to the program that provides health care for about 644,000 Mississippians who are elderly, disabled, poor pregnant women and poor children. Technically, the program would cease to exist so Thursday’s special session is about as important as they come.
The Legislature did not take care of its Medicaid business during the 2013 regular session because Democrats in the House wanted to be able to vote on the expansion that is allowed under the new federal law. Gunn, as already established, is against expansion and used extraordinarily legislative tactics to block that vote. The result was that the existing program was not funded or reauthorized for the new fiscal year.
During the special session, the legislative leadership is expected to take advantage of the House and Senate rules – or more precisely the differences in those rules – to try to ensure no vote on expansion, at least in the House.
The governor has put two items on the call – funding the program and reauthorizing it. At some point, the Legislature most likely also will try to pass a bill to levy the various taxes on health care providers – nursing homes and hospitals – to help fund the program, but that will take a larger-and-harder-to-obtain three-fifths majority.
It is generally accepted that the governor establishes the subject for the special session, but how that subject is dealt with is a legislative decision. If the Legislature wants to deal with expanding Medicaid to cover those earning up to 138 percent of the federal poverty level – or about $15,000 annually for an individual – while funding and re-enacting the program, that would be a reasonable interpretation of the legislative rules, according to most experts.
Some might argue that expanding Medicaid would not be allowed because the governor did not include that specifically in his agenda for the special session, but there are several precedents that would dispute that assumption.
On the other hand, the House rules say – and have for years – that code sections cannot be added to a bill by amendment. The House leadership most likely will introduce and take up a Medicaid reauthorization bill that does not include the eligibility code section. If someone tries to offer an amendment to expand Medicaid, the speaker would be well within his authority to rule the amendment out of order since the eligibility code section is not in the bill.
Now understand that House leaders could just as easily introduce a bill with the eligibility code section in it, but they do not want to because they want to block a vote on expansion.
In the Senate, code sections can be added to legislation as long as the code section is related to the original subject matter of the bill. So it is safe to assume the expansion amendment could be offered to any Medicaid reauthorization bill originating in the Senate.
But Reeves, who presides over the Senate, already has said the legislation would originate in the House. If anyone in the Senate tries to add the expansion legislation to a House bill that does not include the code section, it could theoretically kill the bill when it is returned to the House.
That is how the legislative leadership – not the proclamation issued by the governor – could block a Medicaid expansion vote during Thursday’s special session.
Most observers question whether the Democratic minority would have the votes to pass expansion even if a vote is allowed. But for whatever reason, the Republican leaders want not only to block Medicaid expansion, but also block a vote on the issue.
Contact Capitol correspondent BOBBY HARRISON at bobby.harrison@journalinc.com.